Transient osteoporosis of pregnancy in a case of postpartum bilateral femoral neck fracture

Transient osteoporosis of pregnancy (TOP) is a rare, yet under-reported condition that threatens pregnant women in the third trimester of a usually uneventful pregnancy. It is known to be the consequence of drastic loss of bone mass and elevated rates of bone turnover caused by fetal consumption of calcium and vitamin D from the maternal skeleton (1, 2). Meanwhile, the transient nature of osteoporosis cannot generally be determined at the time of the event, mainly due to the lack of bone mineral density (BMD) history. With respect to our published article “Undesired effect of excessive betamethasone administration during pregnancy: A rare case” in volume 16, issue 3 of your journal (3), we were highly concerned about TOP based on the characteristics of the fracture. However, due to lack of adequate information of previous BMD, this concern could not be supported at that time and postpartum bilateral femoral neck fracture was the reported diagnosis instead. Therefore, we prescribed teriparatide in addition to calcium and vitamin D supplementation for the management of low BMD of the patient, which was discontinued after three months due to the high cost of the drug for her.